Provider Demographics
NPI:1992418974
Name:BUIKEMA, LAURA BETH (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:BUIKEMA
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:ELBY
Other - Middle Name:
Other - Last Name:BUIKEMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 684455
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78768-4455
Mailing Address - Country:US
Mailing Address - Phone:512-240-2293
Mailing Address - Fax:
Practice Address - Street 1:823 CONGRESS AVE.
Practice Address - Street 2:STE #150-684455
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3643
Practice Address - Country:US
Practice Address - Phone:512-775-4771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90927101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health